Young men's sexual health decision making: a qualitative study

Stamp, Michelle Amina (2015) Young men's sexual health decision making: a qualitative study. Doctoral thesis, Northumbria University.

Preview

Text (Professional doctorate thesis) stamp.michelle_Prof Doc.pdf - Submitted Version Download (4MB) | Preview

Abstract

The National Chlamydia screening programme in England screens only half the number of men compared with women, and the places men are being screened for chlamydia differ from that of women (NCSP, 2012). There is a wealth of data which shows that men are being screened in non-clinical settings, such as educational establishments, or that they are choosing to self-request screening via the internet as opposed to seeking alternative health service provision. However, we are unsure of the reasons for their choice. Furthermore, it is unclear what the impact of a positive or negative diagnosis for chlamydia has on subsequent sexual behaviour. By adopting a situational, qualitative methodology, this study aimed to understand the complex factors involved in men’s sexual health decision making following a request for a home testing kit for chlamydia.

The focus for this study was young men aged 20 to 24 years who have a high rate of chlamydia infection, and who have been screened through the National Chlamydia screening programme in the North East of England. Data was collected through ten in-depth interviews, and seven follow up interviews after 12 months. Follow up interviews were primarily used to gauge any long term behaviour change. Patients’ sexual health records provided additional data which was used for triangulation. Data was analysed with the use of framework analysis. Findings from the research were presented to a focus group of professionals and the outcomes from that discussion have been implemented in sexual health provision locally. This research has also fed into a national working group which reviewed chlamydia testing guidelines for positive patients.

Findings show that the decisions the young men made about sexual partners and sexual practice are based on a number of factors: pre-influencing factors, which were based on the men’s perceptions and beliefs about women, categorising them as “risky” with a sexually transmitted infection or “clean” with no infections, alcohol use and contraception vs STI prevention . Situational factors including sexual gratification and sexual arousal and post rationalisation factors such as peer pressure and masculinity. Factors influencing decisions to seek testing were triggered by unprotected sex with casual partners, strengthened by catalytic influences including media campaigns. The findings suggest a negative chlamydia test result gives respondents a clean bill of health allowing them to engage in further unprotected sex. A positive diagnosis resulted in the intention to change behaviour and modify sexual practice. After follow up interviews, intention did not lead to actual behaviour change and many became re-infected within 6 months. A conceptual model based on the study findings has been developed for use in professional practice. This
model identifies the variables which influence the men’s decision making at different stages in the decision making process. This study has shown that the factors that influence young men’s sexual decision making and the impact of diagnosis on subsequent sexual behaviour have major implications for public health in terms of reinfection and further transmission.

Actions (login required)

View Item

Downloads